Posted Date: October 19, 2015
The lifetime risk of breast cancer for BRCA gene mutation carriers is between 56% and 84% (Journal of Clinical Oncology, 2012), and Ashkenazi Jewish women carry the BRCA mutation at least 10 times the rate seen in the general population. However, approximately half of these women are not eligible for insurance coverage for genetic testing due to a lack of family history (Genetics in Medicine, 2009).
An op-ed piece by Elizabeth Wurtzel, published in the New York Times, highlights the importance of BRCA genetic testing, specifically in Ashkenazi Jewish women. There is a high prevalence of BRCA1 and BRCA2 gene mutations in Jewish women of Eastern European decent (Ashkenazi Jews). One in 40 Ashkenazi Jews has the BRCA gene mutation, compared to one in 400 for the rest of the population. Wurtzel states that medical insurers should cover genetic testing for all Ashkenazi Jewish women, regardless of family history. She reinforces her argument citing a UCLA study showing 62 breast cancers are prevented for every 10,000 Ashkenazi Jewish women tested. Wurtzel regrets not being aware of her risk, and her breast cancer had spread to five lymph nodes at the time of her double mastectomy. At the time her article was published, she was in the midst of aggressive chemotherapy and radiation therapy. Even if she had been better informed about her risk, she did not fall in the testing parameters for insurance coverage. Wurtzel makes a compelling argument that Ashkenazi Jewish women must be pro-active in this regard, so as to arrange testing and prophylactic mastectomy rather than endure the consequences of a breast cancer diagnosis.